Surgical treatment of acute type A aortic dissection
AIM: To summarize the surgical experience for acute Stanford A aortic dissection. METHODS: From January 2003 to October 2008, 17 patients with acute Stanford A aortic dissection underwent surgery. The age of the patients ranged from 21 to 62 with the average age of 41.8. The operations were performed by deep hypothermic circulatory arrest (DHCA) with antegrade selective cerebral perfusion (ASCP) in 10 cases (59%), DHCA in 3 cases ( 18% ), and moderate hypothermic cardiopulmonary bypass in 4 cases (23%). Surgical procedures included ascending and total arch grafting with stent elephant trunk technique in 7 eases, ascending and total arch grafting in 2 cases, ascending and hemiarch grafting in 3 eases, and ascending aortic grafting in 5 cases. RESULTS: The operative mortality was 12%. Neurocngnitive deficits occurred in 4 cases (24%). Five-teen patients were followed up for 1 months to 4 years and no death occurred. CONCLUSION: Patients with acute Stanford A aortic dissection must be treated by operation at earliest time if possible. The choice of surgical procedures depends on the location of intimal tear and the range of dissection. The key points to achieve optimal results in acute Stanford A aortic dissection surgery include skilled surgical procedures, cardiopulmoeary technique and brain protections.
NETL
NSTL
万方数据
维普
